Mercy Hospi­tal’s planned clo­sure is a stark ex­am­ple of struc­tural racism

Chicago Sun-Times - - OPINION -

Many Chicagoans who work or live on the South Side may have been shocked by the re­cent an­nounce­ment that Mercy Hospi­tal and Med­i­cal Cen­ter plans to close af­ter more than 150 years of serv­ing the com­mu­nity. We were not.

As lead­ers of a com­mu­nity health cen­ter serv­ing many of those who will be af­fected by the clo­sures of safety-net hos­pi­tals like Mercy, we get a front-row view of the chal­lenges these in­sti­tu­tions face. An out­side ob­server might be ex­cused for think­ing that Mercy Hospi­tal was thriv­ing, judg­ing from its busy in­pa­tient, out­pa­tient and emer­gency de­part­ments, as well as its high daily av­er­age cen­sus.

But Mercy is clos­ing for rea­sons that have noth­ing to do with de­mand.

In­stead, we need to look at the

Amer­i­can health care sys­tem, and Illi­nois Med­i­caid in par­tic­u­lar, to un­der­stand how they are fail­ing in­sti­tu­tions that serve the poor and peo­ple of color. It is a per­fect ex­am­ple of struc­tural racism.

Med­i­caid is de­signed pri­mar­ily to serve the poor, and its en­rollees are dis­pro­por­tion­ately Black and Brown. While 32% of Illi­noisans are African

Amer­i­can or Latino, these groups com­prise 55% of all Illi­nois Med­i­caid en­rollees.

At the same time, Illi­nois Med­i­caid has grossly un­der­paid physi­cians, hos­pi­tals, and oth­ers who pro­vide care to our most vul­ner­a­ble res­i­dents. When the state proudly an­nounced re­cently that the Med­i­caid fee schedule would be in­creased, the re­sult was still only 60% of what Medi­care pays. Worse yet, Med­i­caid tends to fa­vor in­pa­tient care over both out­pa­tient pro­ce­dures and spe­cialty care, pre­cisely while im­prove­ments in care have led to a de­crease in the num­ber of pa­tients who need to be ad­mit­ted to a hospi­tal.

As a re­sult, safety-net hos­pi­tals like Mercy are on a col­li­sion course with in­sol­vency. More im­por­tantly, the sit­u­a­tion leaves the com­mu­ni­ties they serve in cri­sis, with large num­bers of low-in­come African

Amer­i­cans and Latino res­i­dents los­ing ac­cess to vi­tal ser­vices in their neigh­bor­hoods, par­tic­u­larly di­ag­nos­tic, out­pa­tient and spe­cialty care.

It’s as close as you can get to a text­book def­i­ni­tion of struc­tural racism: a sys­tem set up by our gov­ern­ment that leads to fewer, low­erqual­ity ser­vices for Black and Brown com­mu­ni­ties be­cause it re­fuses to pay the ac­tual cost of those ser­vices.

If we want hos­pi­tals in our most vul­ner­a­ble com­mu­ni­ties to stop clos­ing, and lend cre­dence to our call for an end to health in­equities af­fect­ing Chicagoans of color, it is im­per­a­tive that we in­crease Med­i­caid rates to cover the ac­tual cost of pro­vid­ing high-qual­ity care for all.

Dan Ful­wiler, MPH, Pres­i­dent and CEO Car­men Ver­gara, RN, MPH, COO Esper­anza Health Cen­ters

Send let­ters to let­ters@sun­

Jitu Brown, direc­tor of Jour­ney 4 Jus­tice, and a group of ac­tivists speak out ear­lier this month against the planned clo­sure of Mercy Hospi­tal and Med­i­cal Cen­ter in Bronzevill­e.

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